Les perceptions des femmes tunisiennes selon le modèle des croyances liées à la santé et leurs pratiques relativement à l’ostéoporose

Introduction: L'étude a pour objectif de décrire les croyances des femmes et leurs pratiques liées à la santé et à l'ostéoporose, afin d'élaborer des interventions efficaces et ciblées pour la prévention de cette maladie dans le contexte tunisien. Méthodes: Une étude descriptive transversale a été effectuée auprès de 100 femmes tunisiennes, âgées de 45 ans et plus, qui consultent au centre de santé de base d'une zone périurbaine de la région de Sousse (Tunisie). La collecte de l'information a été réalisée à l'aide de  l'échelle des croyances relatives à la santé sur l'ostéoporose développée par Kim et ses collègues traduit en arabe et validé en Tunisie et le questionnaire de Calcul des apports calciques quotidiens développé par Fardellone Patrice. L'interprétation des résultants s'est basée sur le Health Belief Model. Résultats: La perception des participantes pourrait être considérée comme au dessus de la moyenne pour la vulnérabilité de l'ostéoporose (58%), la gravité de la maladie, les avantages de la pratique de l'activité physique, les avantages de l'apport en calcium et la motivation à la santé; par contre, elle pourrait être considérée comme modérée concernant les obstacles à la prévention. Cependant, les pratiques exposant au risque de la maladie sont relativement fréquentes et ceci essentiellement en rapport avec des facteurs socio-économiques et culturels. Conclusion: Les programmes de promotion doivent viser la création d'un environnement physique et social favorable à l'adoption des comportements à moindre risque et viser l'éducation ciblée de la population.Pan African Medical Journal 2016; 23:4

Clustering of risk factors in the smoking habits of schoolchildren in Sousse, Tunisia

Background: In Tunisia, little is known about the association between tobacco use and other chronic disease risk factors. This is the case for both adults and children. It is important to know the characteristics of young smokers to facilitate the creation and implementation of future programs for tobacco prevention. Aim: The aim of this study was to determine the association between tobacco use and other lifestyle factors among schoolchildren in Tunisia. Methods: We conducted a 2009/2010 cross-sectional questionnaire survey of 4003 randomly selected school children aged 13 years old (7th and 9th grades) to evaluate their knowledge, attitudes towards, and beliefs about the three risk factors for chronic disease (unhealthy diet, physical inactivity, and tobacco use). Written informed consent was obtained from each child's parents who allowed their child to participate. Results: The mean age of our sample was 13.36±1.28 years. The proportions of daily smokers were 2.2% and 0.1% among boys and girls, respectively. The proportions of irregular smokers were 9.1% and 1.5% among boys and girls, respectively. In our population, 19.1% (n=767) had ever experimented to smoke, with 29.8% among boys and 9% among girls (p<0.001). The proportions of schoolchildren who reported daily participation in physical activity were different between smokers and nonsmokers with 17.7% and 11.5%, respectively (p=0.03). Concerning eating habits, there was no significant difference in the consumption of fruits and vegetables; however, smokers frequently ate more high fat foods and in fast food restaurants. Similar results were found while comparing regular smoking children with those who experimented but who never became hooked on smoking. Conclusion: This study and previous research suggest the importance of early intervention in adolescents on smoking and combing these efforts with interventions focusing on physical activity and dietary habit

Conservative management of post-appendicectomy intra-abdominal abscesses

<p>Abstract</p> <p>Purpose</p> <p>Appendicitis is the most common abdominal inflammatory process in children which were sometimes followed by complications including intra-abdominal abscess. This later needs classically a surgical drainage. We evaluated the efficacy of antibiotic treatment and surgical drainage.</p> <p>Methods</p> <p>Hospital records of children treated in our unit for intra-abdominal post appendectomy abscesses over a 6 years period were reviewed retrospectively.</p> <p>Results</p> <p>This study investigates a series of 14 children from 2 to 13 years of age with one or many abscesses after appendectomy, treated between 2002 and 2007. Seven underwent surgery and the others were treated with triple antibiotherapy. The two groups were comparable.</p> <p>For the 7 patients who receive medical treatment alone, it was considered efficient in 6 cases (85%) with clinical, biological and radiological recovery of the abscess. There was one failure (14%). The duration of hospitalization from the day of diagnosis of intra-abdominal abscess was approximately 10.28 days (range 7 to 14 days). In the other group, the efficacy of treatment was considered satisfactory in all cases. The duration of hospitalization was about 13 days (range: 9 to 20).</p> <p>Conclusion</p> <p>Compared to surgical drainage, antibiotic management of intra-abdominal abscesses was a no invasive treatment with shorter hospitalization.</p

Uncovering the clinical relevance of unclassified variants in DNA repair genes: a focus on BRCA negative Tunisian cancer families

Introduction: Recent advances in sequencing technologies have significantly increased our capability to acquire large amounts of genetic data. However, the clinical relevance of the generated data continues to be challenging particularly with the identification of Variants of Uncertain Significance (VUSs) whose pathogenicity remains unclear. In the current report, we aim to evaluate the clinical relevance and the pathogenicity of VUSs in DNA repair genes among Tunisian breast cancer families.Methods: A total of 67 unsolved breast cancer cases have been investigated. The pathogenicity of VUSs identified within 26 DNA repair genes was assessed using different in silico prediction tools including SIFT, PolyPhen2, Align-GVGD and VarSEAK. Effects on the 3D structure were evaluated using the stability predictor DynaMut and molecular dynamics simulation with NAMD. Family segregation analysis was also performed.Results: Among a total of 37 VUSs identified, 11 variants are likely deleterious affecting ATM, BLM, CHEK2, ERCC3, FANCC, FANCG, MSH2, PMS2 and RAD50 genes. The BLM variant, c.3254dupT, is novel and seems to be associated with increased risk of breast, endometrial and colon cancer. Moreover, c.6115G&gt;A in ATM and c.592+3A&gt;T in CHEK2 were of keen interest identified in families with multiple breast cancer cases and their familial cosegregation with disease has been also confirmed. In addition, functional in silico analyses revealed that the ATM variant may lead to protein immobilization and rigidification thus decreasing its activity. We have also shown that FANCC and FANCG variants may lead to protein destabilization and alteration of the structure compactness which may affect FANCC and FANCG protein activity.Conclusion: Our findings revealed that VUSs in DNA repair genes might be associated with increased cancer risk and highlight the need for variant reclassification for better disease management. This will help to improve the genetic diagnosis and therapeutic strategies of cancer patients not only in Tunisia but also in neighboring countries

Clinical and genetic investigation of pediatric cases of Wolff-Parkinson-White syndrome in Tunisian families.

International audienceBACKGROUND: Wolff-Parkinson-White (WPW) syndrome is an autosomal-dominant heart disease characterized by an accessory pathway that arises from an aberrant conduction from the atria to the ventricles. Several mutations within the PRKAG2 gene were shown to be responsible for WPW. This gene encodes the γ2 regulatory subunit of adenosine monophosphate (AMP)-activated protein kinase, which functions as a metabolic sensor in cells, responding to cellular energy demands. METHODS: This first study of WPW in a North African population comprises the clinical and genetic investigation of 3 Tunisian families, including 11 affected members. The involvement of the PRKAG2 and NKX2-5 genes was investigated. RESULTS: Mutation screening showed that with the exception of two already reported single-nucleotide polymorphisms, no mutations were detected within the coding region of PRKAG2 or in the NKX2-5 gene. CONCLUSIONS: This study provides further evidence of the genetic heterogeneity of WPW

First Report of Anacampsis scintillella on Halimium halimifolium in Sejnane (Bizerte, Tunisia)

At the beginning of April 2010, larvae of Orgyia trigotephras and Anacampsis scintillella caused severe plant defoliation in the region of Sejnane situated in the north of Tunisia. A. scintillella was observed on totally defoliated Halimium halimifolium plants. Larvae and pupae of A. scintillela were protected between two or three leaves of the host plant. Life history of A. scintillella is poorly studied, so far. In this paper, we presented a first report of this pest in Tunisia

Clustering of risk factors in the smoking habits of schoolchildren in Sousse, Tunisia

Abstract Background: In Tunisia, little is known about the association between tobacco use and other chronic disease risk factors. This is the case for both adults and children. It is important to know the characteristics of young smokers to facilitate the creation and implementation of future programs for tobacco prevention. Aim: The aim of this study was to determine the association between tobacco use and other lifestyle factors among schoolchildren in Tunisia. Methods: We conducted a 2009/2010 cross-sectional questionnaire survey of 4003 randomly selected school children aged 13 years old (7th and 9th grades) to evaluate their knowledge, attitudes towards, and beliefs about the three risk factors for chronic disease (unhealthy diet, physical inactivity, and tobacco use). Written informed consent was obtained from each child’s parents who allowed their child to participate. Results: The mean age of our sample was 13.36±1.28 years. The proportions of daily smokers were 2.2% and 0.1% among boys and girls, respectively. The proportions of irregular smokers were 9.1% and 1.5% among boys and girls, respectively. In our population, 19.1% (n=767) had ever experimented to smoke, with 29.8% among boys and 9% among girls (p&lt;0.001). The proportions of schoolchildren who reported daily participation in physical activity were different between smokers and nonsmokers with 17.7% and 11.5%, respectively (p=0.03). Concerning eating habits, there was no significant difference in the consumption of fruits and vegetables; however, smokers frequently ate more high fat foods and in fast food restaurants. Similar results were found while comparing regular smoking children with those who experimented but who never became hooked on smoking. Conclusion: This study and previous research suggest the importance of early intervention in adolescents on smoking and combing these efforts with interventions focusing on physical activity and dietary habits.</jats:p

Spirometric “Lung Age” estimation for North African population

Background: Published reference equations predicting Estimated-Lung-Age (ELA) did not reliably predict Chronological-Lung-Age (CLA) data in North African population. Aims: To develop and to validate novel reference equations for ELA from varied anthropometric data and FEV1. Methods: Applying multiple regression analysis, equations predicting ELA were invented using data from 540 never-smokers with normal spirometry (group I). Validation was made based on data from 41 never-smokers with normal spirometry (group II). Equations were further applied for 91 subjects with confirmed COPD. Results: Novel regression equations allowing prediction of reference value of ELA and normal limits of difference between ELA and CLA were elaborated in both sexes. In males, ELA (yrs) = 42.85 − 20.74 × FEV1 (L) + 47.41 × Body Surface Area (m2) − 0.62 × Body-Mass-Index (BMI, kg/m2). In females, ELA (yrs) = 64.64 − 8.00 × FEV1 (L) − 0.17 × BMI (kg/m2) + 8.82 × Height (m). Normal limits of difference between ELA and CLA were ±16.9 yrs in males and ±14.8 yrs in females. Established equations predicted ELA of group II with no significant difference between CLA and ELA in either sex (respectively, 42.9 ± 16.6 vs. 40.3 ± 13.7 yrs in males, 42.0 ± 13.5 vs. 45.6 ± 7.7 yrs in females) ELA was significantly older than CLA age only in COPD with grades III and IV ((ELA minus CLA) (yrs) averaged, respectively, +21.7, +26.4). Conclusion: North African reference equations enrich the World Bank of reference equations from which the physician should choose according to the patient’s ethnic background

Lack of association between the angiotensin-converting enzyme gene (I/D) polymorphism and diabetic nephropathy in Tunisian type 2 diabetic patients

International audienceObjective. The aim of the present study was to investigate whether the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism is associated with diabetic nephropathy and type 2 diabetes in the Tunisian population. Design. A case-control study was conducted among 141 unrelated type 2 diabetic patients with (90 patients) or without nephropathy (51 patients) and 103 non-diabetic controls with normal fasting blood glucose. Genotyping was performed using a nested polymerase chain reaction amplification in order to identify correctly heterozygous individuals. Results. The distribution of DD, ID and II genotypes did not significantly differ between type 2 diabetic patients with or without nephropathy (DD: 44%; ID: 46%; II: 10% vs. DD: 41%; ID: 47 %; II: 12%, respectively). There was also no significant statistical difference between the genotype distribution and allele frequencies of the (I/D) polymorphism in all type 2 diabetic subjects compared to non-diabetic controls with normal fasting blood glucose (DD: 43%; ID: 46%; II: 11% vs. DD: 37%; ID: 48%; II: 15%, respectively). Conclusions. In the present preliminary study, the (I/D) polymorphism within the ACE gene is likely not associated with diabetic nephropathy nor with type 2 diabetes in the Tunisian studied population